Assessing a Pharmacist-Enabled Intervention to Improve Adherence to Medication for Hypertension, Dyslipidemia, and Chronic Venous Circulation Disorders in Greece

Figures & data

Figure 1 Patient self-reported adherence questionnaire.

Table 1 Patient Characteristics, Clinical Diagnosis, and Current Management Status

	N=1146	%
Sex
Men	550	48
Women	596	52
Age
18–24 years	1	0.1
25–34 years	5	0.4
35–44 years	53	4.6
45–54 years	178	15.5
55–64 years	286	25.0
65–74 years	390	34.0
75–84 years	193	16.9
85+ years	40	3.5
Region of residence
Attica	750	65.4
Peloponnese	396	34.6
Diagnosed disease
Hypertension	272	23.7
Dyslipidemia	189	16.5
Chronic venous circulation disorder	35	3.0
Hypertension and dyslipidemia	487	42.5
Hypertension and chronic venous circulation disorder	35	3.1
Dyslipidemia and chronic venous circulation disorder	30	2.6
Hypertension, dyslipidemia and chronic venous circulation disorder	98	8.6
Pills for dyslipidemia (N=804)
1 per day	745	92.7
2 per day	56	7.0
3 per day	3	0.3
More than 3 per day	0	0.0
Pills for hypertension (N=892)
1 per day	624	70.0
2 per day	214	24.0
3 per day	40	4.5
More than 3 per day	14	1.5
Pills for chronic venous circulation disorder (N=198)
1 per day	112	56.5
2 per day	68	34.2
3 per day	11	5.6
More than 3 per day	7	3.7

Table 2 Difference in Adherence Pre-Intervention (Month 1) and Post-Intervention (Month 4)

Variable	Month	Median	IQR	Paired Samples Wilcoxon Test, p-value
Forget to take prescribed medications	0	2	1	<0.001*
	4	2	1
Careless about medications during the last 30 days	0	2	2	<0.001*
	4	2	1
Temporarily discontinue medications without prior doctor’s advice	0	2	2	<0.001*
	4	1	1

Note: *Significant at p<0.001.

Table 3 Impact of Pharmacist Intervention on Adherence According to Clinical Diagnosis

	Dyslipidemia (n=189)			Hypertension (n=272)			CVCD (n=35)			Dyslipidemia, Hypertension (n=487)			Dyslipidemia, CVCD (n=30)			Hypertension, CVCD (n=35)			Dyslipidemia, Hypertension, CVCD (n=98)
Forget to take prescribed medications	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4(%,n)	p	M0 (%,n)	M4 (%,n)	p	M0(%,n)	M4(%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0(%,n)	M4 %,n)	p
Never	20.7(39)	35.4(67)	<.001*	24.2(66)	44.9(122)	<.001*	28.55(10)	45.7(16)	0.10	20.4(99)	37.2(181)	<0.001*	30(9)	36.7(11)	0.12	20(7)	37.1(13)	0.0	26.5(26)	39.8(39)	0.07
Rarely	24.3(46)	43.4(82)		27.2(74)	36.8(100)		28.55(10)	20(7)		31.4(153)	46.0(224)		30(9)	33.3(10)		40(14)	45.7(16)	4	38.8(38)	32.7(32)
Sometimes	29.6(56)	17.5(33)		29.8(81)	15(41)		22.9(8)	25.7(9)		30(146)	15.2(74)		23.3(7)	26.7(8)		37.1(13)	8.6(3)		23.5(23)	20.4(20)
Often	23.8(45)	3.7(7)		17.3(47)	3.3(9)		14.3(5)	5.7(2)		16.4(80)	1.6(8)		10(3)	3.3(1)		0.0	8.6(3)		11.2(11)	7.1(7)
Always	1.6(3)	0()		1.5(4)	0		5.7(2)	2.9(1)		1.8(9)	0		6.7(2)	0		2.9(1)	0		0	0
Careless about medications during the last 30 days	M0 (%,n)	M4 (%,n)	p	M0(%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p
Never	36.5(69)	47.6(90)	<.001*	37.5(102)	51.1(139)	<.001*	37.1(13)	51.4(18)	0.16	37.8(184)	48.3(235)	<.001*	53.3(16)	56.6(17)	0.04	42.85(15)	42.85(15)	0.57	42.8(42)	42.8(42)	0.15
Rarely	20.1(38)	34.4(65)		21.3(58)	32.7(89)		20(7)	20(7)		21.6(105)	34.3(167)		6.7(2)	36.7(11)		17.1(6)	34.25(12)		23.5(23)	32.7(32)
Sometimes	28.5(54)	14.8(28)		26.9(73)	12.9(35)		22.9(8)	20(7)		27.3(133)	14.3(70)		30(9)	6.7(2)		28.55(10)	17.1(6)		25.5(25)	21.4(21)
Often	13.8(26)	3.2(6)		14.3(39)	2.9(8)		17.1(6)	8.6(3)		12.7(62)	3.1(15)		6.7(2)	0		11.5(4)	2.9(1)		9.2(8)	3.1(3)
Always	1.1(2)	0(0)		0	0.4(1)		2.9(1)	0		0.6(3)	0		3.3(1)	0		0	2.9(1)		0	0
Temporarily discontinue medications without prior doctor’s advice	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4 (%,n)	p	M0 (%,n)	M4(%,n)	p
Never	37(70)	50.3(95)	<.001*	39.7(108)	53.7(146)	<.001*	37.1(13)	57.1(20)	0.38	44.6(217)	56(273)	<.001*	46.7(14)	40(12)	0.28	45.7(16)	51.4(18)	0.67	48(47)	50(49)	0.16
Rarely	16.4(31)	32.3(61)		16.9(46)	30.9(84)		28.55(10)	20(7)		15.0(73)	27.5(134)		16.7(5)	50(15)		17.1(6)	31.4(11)		18.3(18)	27.6(27)
Sometimes	29.1(55)	15(28)		27.9(76)	12.9(35)		28.55(10)	14.3(5)		28.7(140)	13.4(65)		30(9)	6.7(2)		25.7(9)	8.6(3)		23.5(23)	18.3(18)
Often	16.4(31)	1.8(4)		15.5(42)	2.5(7)		2.9(1)	8.6(3)		10.5(51)	3.1(15)		3.3(1)	3.3(1)		11.5(4)	5.7(2)		10.2(10)	4.1(4)
Always	1.1(2)	0.6(1)		0	0		2.9(1)	0		1.2(6)	0		3.3(1)	0		0	2.9(1)		0	0

Notes: *Significant at p<0.001.

Abbreviations: CVCD, chronic venous circulation disorder; M0, month 0; M4, month 4.

Table 4 Differences in Adherence to Treatment, in Month 0 vs Month 4, Relative to Diagnosis and Pill Burden

Dyslipidemia (Pills Per Day) (N=189)	Variable	Month	Median	IQR	Paired Samples Wilcoxon Test, p-value
1	Forget to take prescribed medications	0	3	2	<0.001**
		4	2	1
	Careless about medications during the last 30 days	0	2.5	2	<0.001**
		4	2	1
	Temporarily discontinue medications without prior doctor’s advice	0	2	2	<0.001**
		4	1	1
2+	Forget to take prescribed medications	0	3	1	1
		4	2.5	1
	Careless about medications during the last 30 days	0	3	1.25	0.4879
		4	2.5	1
	Temporarily discontinue medications without prior doctor’s advice	0	3	2	0.8241
		4	2	1
Hypertension (pills per day) (N=272)	Variable	Month	Median	IQR	Paired Samples Wilcoxon Test, p-value
1	Forget to take prescribed medications	0	3	2	<0.001**
		4	2	1
	Careless about medications during the last 30 days	0	2	2	<0.001**
		4	1	1
	Temporarily discontinue medications without prior doctor’s advice	0	2	2	<0.001**
		4	1	1
2+	Forget to take prescribed medications	0	2	1	0.0020641*
		4	2	1.75
	Careless about medications during the last 30 days	0	2	2	0.02894*
		4	2	1
	Temporarily discontinue medications without prior doctor’s advice	0	1.5	2	0.03596*
		4	1	1
CVCD (pills per day) (N=35)	Variable	Month	Median	IQR	Paired Samples Wilcoxon Test, p-value
1	Forget to take prescribed medications	0	2	2	0.08
		4	2	2
	Careless about medications during the last 30 days	0	2	2	0.1045
		4	1	2
	Temporarily discontinue medications without prior doctor’s advice	0	2	2	0.03636*
		4	1	1
CVCD (pills per day) (N=35)	Variable	Month	Median	IQR	Paired Samples Wilcoxon Test, p-value
2+	Forget to take prescribed medications	0	2	1.75	0.4098
		4	2	1.75
	Careless about medications during the last 30 days	0	1.5	2	0.9313
		4	2	1.75
	Temporarily discontinue medications without prior doctor’s advice	0	2	1.75	0.9153
		4	2	2
Dyslipidemia and hypertension (pills per day) (N=487)	Variable	Month	Median	IQR	Paired Samples Wilcoxon Test, p-value
1–2	Forget to take prescribed medications	0	3	1	<0.001**
		4	2	1
	Careless about medications during the last 30 days	0	2	2	<0.001**
		4	1	1
	Temporarily discontinue medications without prior doctor’s advice	0	2	2	<0.001**
		4	1	1
3+	Forget to take prescribed medications	0	2	1	<0.001**
		4	2	1
	Careless about medications during the last 30 days	0	2	2	<0.001**
		4	2	1
	Temporarily discontinue medications without prior doctor’s advice	0	1	2	0.002897*
		4	1	1
Dyslipidemia and CVCD (pills per day) (N=35)	Variable	Month	Median	IQR	Paired Samples Wilcoxon Test, p-value
1–2	Forget to take prescribed medications	0	2	2	0.6788
		4	1	1
	Careless about medications during the last 30 days	0	1	2	0.2652
		4	1	1
	Temporarily discontinue medications without prior doctor’s advice	0	2	2	0.6653
		4	2	1
3+	Forget to take prescribed medications	0	2	2.25	0.178
		4	2	1.25
	Careless about medications during the last 30 days	0	1.5	2	0.1049
		4	1	1
	Temporarily discontinue medications without prior doctor’s advice	0	1.5	2	0.2362
		4	2	1
Hypertension and CVCD (pills per day) (N=30)	Variable	Month	Median	IQR	Paired Samples Wilcoxon Test, p-value
1–2	Forget to take prescribed medications	0	2	1.25	0.4023
		4	2	1
	Careless about medications during the last 30 days	0	2.5	2	0.2918
		4	2	2
	Temporarily discontinue medications without prior doctor’s advice	0	2	2	0.3902
		4	2	1.5
3+	Forget to take prescribed medications	0	2	1	0.04007*
		4	2	1
	Careless about medications during the last 30 days	0	1	1.5	0.8605
		4	2	1
	Temporarily discontinue medications without prior doctor’s advice	0	1	1.5	1
		4	1	1
All three (pills per day) (N=98)	Variable	Month	Median	IQR	Paired Samples Wilcoxon Test, p-value
2–3	Forget to take prescribed medications	0	2	2	0.02205*
		4	2	1
	Careless about medications during the last 30 days	0	2	2	0.03585*
		4	2	1
	Temporarily discontinue medications without prior doctor’s advice	0	2	2	0.02908*
		4	1	1
4+	Forget to take prescribed medications	0	2	1.25	0.3271
		4	2	2
	Careless about medications during the last 30 days	0	2	2	0.1854
		4	2	2
	Temporarily discontinue medications without prior doctor’s advice	0	1.5	2	0.815
		4	2	1.75

Notes: **Significant at p<0.001, *Significant at p<0.05.